• Paul Chinardet, Floriane Gilles, Helene Cochet, Jonathan Chelly, QuenotJean-PierreJPIctalGroup, Le Chesnay, France.Department of Intensive Care, François Mitterrand University Hospital, Dijon, France., Gwenaelle Jacq, Pauline Soulier, Olivier Lesieur, Pascal Beuret, Mathilde Holleville, Cedric Bruel, Pierre Bailly, Bertrand Sauneuf, Caroline Sejourne, Arnaud Galbois, Candice Fontaine, François Perier, Nicolas Pichon, Marine Arrayago, Nicolas Mongardon, David Schnell, LascarrouJean-BaptisteJBIctalGroup, Le Chesnay, France.Intensive Care Unit, Centre Hospitalier Universitaire Hôtel-Dieu, Nantes Cedex, France., Raphaële Convers, and Stephane Legriel.
• Medical-Surgical Intensive Care Unit, Centre Hospitalier de Versailles - Site André Mignot, Le Chesnay Cedex, France.
• Crit. Care Med. 2023 Mar 1; 51 (3): 388400388-400.

ObjectivesTo describe early electrocardiogram (ECG) abnormalities after status epilepticus (SE) and evaluate their association with 90-day neurological outcomes.DesignRetrospective analysis of a multicenter, national prospective registry between February 2018 and June 2020.SettingSixteen ICUs in France, IctalGroup Research Network.PatientsAdults with available ECG performed less than or equal to 24 hours after the onset of SE and less than or equal to 12 hours after its resolution.InterventionDouble-blinded review of all ECGs was performed by two independent cardiologists. ECGs were categorized as normal/abnormal and then with minor/major early ECG abnormalities according to the Novacode ECG Classification system.Measurements And Main ResultsAmong 155 critically ill patients with SE, early ECG abnormalities were encountered in 145 (93.5%), categorized as major in 91 of 145 (62.8%). In addition to sinus tachycardia, the main abnormalities were in the ST segment (elevation [16.6%] or depression [17.9%]) or negative T waves (42.1%). Major early ECG abnormalities were significantly associated with respiratory distress and sinus tachycardia at the scene and hyperlactatemia at ICU admission. By multivariable analysis, three variables were significantly associated with 90-day poor outcome: age, preexisting ultimately fatal comorbidity, and cerebral insult as the cause of SE. Early major ECG abnormalities were not independently associated with 90-day functional outcome.ConclusionsIn our study, early ECG abnormalities in the acute phase of SE were frequent, often unrecognized and were associated with clinical and biological stigma of hypoxemia. Although they were not independently associated with 90-day functional outcome, ECG changes at the early stage of SE should be systematically evaluated.Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT03457831 .Copyright © 2023 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

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